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AIMS: To analyze the epidemiological profile and quality of life (QoL) of patients with special needs and overload their caregivers. METHODS AND RESULTS: Health-related QoL was assessed in a quantitative, observational, cross-sectional study of prospective characteristics using the WHOQOL-BREF and ZARIT-22 questionnaires. This study included 122 patients were included; they were divided into patients without caregiver assistance (n = 63) who answered WHOQOL-BREF, 49 caregivers (n = 49) who responded to ZARIT-22, and 10 patients were secondarily caregivers of their parents and answered the ZARIT-22 + WHOQOL-BREF questionnaires. The WHOQOL-BREF general score was 71.94 ± 10.58, and patients born in urban areas and married had positive correlations (p < .05) with the QoL scores in the physical and social domains. ZARIT-22 scores showed an average of 58.63 ± 14.07. Data cross-checking revealed that patients of white races (p = .030) and who lived in urban regions (p = .003) generated less overload to caregivers. CONCLUSION: In the WHOQOL-BREF analysis, family income was a factor with direct impact, and all caregivers referred to moderate-to-high overload, with an increase in prevalence as far away from the service the patient resides.

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OBJECTIVE: In orthodontic patients submitted to oral hygiene instruction, what is the efficacy of orthodontic toothbrush (O-TB) versus conventional toothbrush (C-TB) on plaque and gingival index reduction in randomized and non-randomized controlled clinical trials? METHODS: Electronic database search was performed on PubMed, ClinicalTrials.gov, Cochrane Library and Google Scholar. Database research, study selection, data extraction and ROBINS-I and Risk of Bias Tool 2.0 analysis were conducted by two independently examiners in duplicate. Two different meta-analyses were performed for plaque index and gingival index, followed by the analysis of overall quality of the evidence using GRADE. RESULTS: A total of 158 studies were identified for screening; six articles were included in qualitative synthesis, and of those, three were subjected to a quantitative synthesis (meta-analysis). Three non-randomized studies presented an overall 'low', 'moderate' and 'high' risk of bias for each one of the articles, and the three randomized clinical trials presented 'low risk' for two articles and 'some concerns' quality for the other one. The overall strength of evidence was ranked 'very low' quality for plaque index and gingival index subgroups. CONCLUSIONS: Gingival bleeding is not modified by orthodontic design toothbrush, but there is circumstantial scientific evidence for recommending the use of an O-TB instead a C-TB based on the analysis of plaque index control. Although major plaque removal of the O-TB was validated by meta-analysis, this improvement is not completely clarified which calls for further clinical studies to assess the effects of using an O-TB compared with a C-TB.

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Congenital Zika syndrome (CZS) constitutes a recently identified malformation caused by Zika virus infection during pregnancy. Limited data is available to date on the facial dysmorphic features of these patients. This study evaluated the facial dysmorphisms of children with CZS, compared with clinically healthy children, using clinical examination and standardized photographic images. Sixty-three children with CZS (9.70 ± 3.2 months-age), and 31 Controls (8.67 ± 6.2 months-age) joined the study. Seven out of 15 indices differed between groups: midfacial height (MFH)/horizontal facial reference (HFR) (p = .0003), interalar distance/HFR (p = .0027), nasal root depth/MFH (p = .0030), posterior nasal length/MFH (p = .0002), vertical position of the ear/MFH (p <.0001), ear length/MFH (p = .0005), chin height/total facial height (CH/TFH) (p <.0001). A CH/TFH of 0.229 showed 93.9% sensitivity and 80.6% specificity in diagnosing CZS. Children with CZS had broad, short faces, decreased intercanthal distance, short posterior nasal length, prominent nasal root, broad nasal wings, and high-set and long ears. Increased chin height index provided the most accurate diagnostic potential.

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PURPOSE: The objective of this systematic review was to evaluate the risk of development of gingival recession (GR) as a result of the combined orthodontic-orthognathic approach. MATERIALS AND METHODS: The PubMed, Google Scholar, ClinicalTrials.gov, and Cochrane Library databases were searched. Included articles mentioned gingival parameters in their materials and methods sections; specifically, they evaluated GR, which was measured before and after the surgical procedure. Study parameters such as methodology, evaluation period, sample characteristics, and follow-up were extracted by 2 authors independently. RESULTS: In total, 133 relevant articles were identified from the databases; after screening and full-text analysis, 9 studies were included in this systematic review. Meta-analysis could not be conducted because of considerable heterogeneity in methods. The incidence of GR in the range of 0.5 to 3.0 mm as a significant clinical finding after orthognathic surgery showed statistically significant differences in all included articles. Among patients with GR, the mean age was 23.0 to 29.5 years and the mandibular incisors were the most common site. However, no case of recession greater than 3.0 mm was associated with surgery. CONCLUSIONS: On the basis of the findings of this review, GR of approximately 0.5 to 3.0 mm is a common finding after the combined orthodontic-orthognathic approach. Although periodontal damage up to 3 mm can be observed as an isolated finding in mainly the incisors, true recession is not associated with orthognathic surgery in general.

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AIMS: This case report describes an orthodontic and aesthetic rehabilitation in a patient with Turner syndrome. METHODS AND RESULTS: Careful anamnesis was performed to find the patient's medical history. Based on dental casts, radiographies and photographies it was observed alterations in the craniofacial complex, in the occlusion and in the dental morphology. For the orthodontic treatment, rapid maxillary expansion was performed, followed by the use of fixed orthodontic appliance. At the end, aesthetic rehabilitation, with direct composite resin veneers, was utilized for the correction of existing diastema. Treatment goals were achieved by observing an improvement in facial and smile harmony. CONCLUSION: The orthodontic treatment followed by aesthetic rehabilitation of dental morphology showed to be feasible in a patient with Turner syndrome based on an early diagnosis and craniofacial growth follow-up.

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OBJECTIVE: This study aimed to assess the prevalence of dental findings on panoramic radiographs (PRs) of patients with osteogenesis imperfecta (OI) and correlate these results with epidemiologic and medical data. STUDY DESIGN: A case-control study was conducted with 24 patients with OI and 48 sex- and age-matched controls. Demographic, clinical, and bisphosphonate regimen-related data were recorded. The outcome variables were the presence or absence of dental alterations in PRs. Mann-Whitney U test, Pearson's χ2 test, and multinomial logistic regression analysis (95% confidence interval) were used (significance level of 5%). RESULTS: OI type 4 demonstrated a high prevalence (62.5%), followed by type 1 (37.5%). With regard to prevalence associated with severity, the moderate form was the most prevalent (P = .028). The mean time of intravenous pamidronate regimen was 6.6 ± 4.4 years. Dentinogenesis imperfecta was observed in 75% of patients with OI, and this group showed a high prevalence of dental abnormalities in comparison with controls (P < .05). Bisphosphonate therapy was associated with ectopic teeth (P = .007) and tooth impaction (P = .033). Pulp obliteration was significant with bisphosphonate treatment over a period of 7 years (P = .026). CONCLUSIONS: This study found a significant prevalence of dental alterations in patients with OI, and certain alterations were associated with bisphosphonate therapy, indicating its influence on the dentin-related physiopathology.

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The aim of this study was to evaluate the degree of conversion (DC), flexural strength (FS), and shear bond strength (SBS) of ceramic brackets bonded to enamel with experimental self-adhesive orthodontic composites. Functional monomers 10-methacryloyloxy-decyl-dihydrogen-phosphate (MDP) and glycerol-dimethacrylate-phosphate (GDMA-P) were used in experimental composites. They were compared to the same composite without an acidic monomer (negative control) and with enamel acid-etching prior to adhesive application (positive control). DC was evaluated by Raman micro-spectroscopy. Flexural three-point bending testing was performed in a universal testing machine. Ceramic brackets were bonded to bovine enamel and SBS was evaluated before and after 2000 thermal-cycles. Fracture patterns were surveyed with manual removal with specific pliers and analyzed by SEM. Statistics was performed using ANOVA and Tukey's test (p < 0.05). DC of the control composite was significantly higher (p < 0.001) than that of GDMA-P and MDP. FS showed no significant difference between composites (p = 0.451). Regarding adhesion, the positive control (8.47 ± 0.88 MPa) and MDP (7.07 ± 2.69 MPa) obtained higher overall results. The predominant fracture pattern of the positive control and MDP was mixed while it was adhesive for further groups. The MDP-containing orthodontic composite attained similar adhesion to a conventional three-step orthodontic bonding system, with a similar fracture pattern and mechanical properties. Nevertheless, the presence of acidic functional monomers reduced the DC.

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Diante da má oclusão de Classe III esquelética por deficiência da maxila, a protração maxilar, precedida ou não pela disjunção palatina, é o procedimento mais utilizado pelos ortodontistas. Entretanto promove compensações dentárias e está limitada a idades muito precoces. O presente artigo tem como objetivo demonstrar, por meio de relato de caso clínico, o tratamento da Classe III esquelética com ancoragem óssea, potencializando os resultados da protração e minimizando os efeitos dentários indesejáveis preconizados pelo protocolo Manhães. Esse tratamento foi utilizado em uma paciente antes do pico do surto de crescimento puberal e incluiu a expansão rápida da maxila, com Hyrax híbrido, associado a elásticos de Classe III sob uso de 24 horas/dia, ligados a um dispositivo suportado por dentes e mini-implantes (MI) e ancoragem mandibular implanto-suportada (Barra Manhães), além do uso da máscara facial noturna. Observou-se considerável avanço maxilar, melhor colaboração, ausência de compensações dentárias e efetivo custo-benefício ao paciente (AU)

Abstract In the presence of skeletal Class III malocclusion due to maxillary deficiency, maxillary protraction preceded or not by palatine disjunction is the procedure most frequently used by orthodontists. However, it promotes dental compensations and it is limited to very early ages. The present article aims to show, through a clinical case report, the treatment of skeletal Class III with bone anchorage, potentiating protraction results and minimizing the undesirable dental effects as recommended by Manhães. This protocol was used in one patient prior to pubertal growth spurt and included rapid maxillary expansion with Hyrax hybrid associated to Class III elastics used 24 hours/day attached to a supported device. by teeth and mini-implants (IM) and implant-supported mandibular anchorage (Barra Manhães) besides the use of nocturnal facial mask. Considerable maxillary advancement, better collaboration, absence of dental compensations and effective cost-benefit to the patient were observed. (AU)

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This research explored the potential of Camellia sinensis-derived teas and active compounds to be used as treatments to prevent dentin wear. Human root dentin slabs were randomly assigned to 5 groups (n = 10) as follows: distilled water (DW, control), epigallocatechin-3-gallate (EGCG), theaflavin gallate derivatives (TF), commercial green tea (GT), and commercial black tea (BT). The samples were submitted to a pellicle formation and an erosive cycling model (5x/day, demineralization using 0.01 M hydrochloric acid/60 s) followed by remineralization (human stimulated saliva/60 min) for three days. The samples were treated for 5 min using the test group solutions between the erosive cycles. Dentin changes were assessed with profilometry analysis and FT-Raman spectroscopy. The data regarding wear were analyzed by ANOVA followed by Tukey's test (p < 0.05). EGCG, TF derivatives, and both regular teas significantly suppressed erosive dentin loss (38-47%, p < 0.05). No obvious changes in the Raman spectra were detected in the specimens; however, the DW group had a minor relationship of 2880/2940 cm-1. The phenolic contents in both green and black tea and the important catechins appear to have protective effects on dentin loss.

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Abstract This research explored the potential of Camellia sinensis-derived teas and active compounds to be used as treatments to prevent dentin wear. Human root dentin slabs were randomly assigned to 5 groups (n = 10) as follows: distilled water (DW, control), epigallocatechin-3-gallate (EGCG), theaflavin gallate derivatives (TF), commercial green tea (GT), and commercial black tea (BT). The samples were submitted to a pellicle formation and an erosive cycling model (5x/day, demineralization using 0.01 M hydrochloric acid/60 s) followed by remineralization (human stimulated saliva/60 min) for three days. The samples were treated for 5 min using the test group solutions between the erosive cycles. Dentin changes were assessed with profilometry analysis and FT-Raman spectroscopy. The data regarding wear were analyzed by ANOVA followed by Tukey's test (p < 0.05). EGCG, TF derivatives, and both regular teas significantly suppressed erosive dentin loss (38-47%, p < 0.05). No obvious changes in the Raman spectra were detected in the specimens; however, the DW group had a minor relationship of 2880/2940 cm−1. The phenolic contents in both green and black tea and the important catechins appear to have protective effects on dentin loss.

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